Ethnic Differences in Dysmorphic Features among Children with Fetal Alcohol Spectrum Disorders

Children adversely affected by prenatal exposure to alcohol display a continuum of dysmorphic features, behavioral and neuropsychological deficits best termed fetal alcohol spectrum disorders (FASD). Alcohol exposure during critical stages of central nervous system and midfacial development leads to the observed pattern. Recent research on FASD focuses increasingly on quantifying physical traits (including head circumference, palpebral fissure length, philtrum length, morphology of the philtrum and vermilion border of the upper lip) and comparing them to specific neurocognitive findings. Various standards and cut-off points have been used by dysmorphologists to determine which of the structural features of children prenatally exposed to alcohol are significant. Many diagnosticians use a cut off point of <10th centile for determining such traits as microcephaly and palpebral fissure length; however, there is considerable debate as to what exactly should constitute these standards and others for the general U.S. population. Furthermore, there is little documentation of ethnic differences in morphology among children diagnosed with FASD. Both child and maternal data from three studies in the Northern Plains of the U.S., Italy, and South Africa were compared and revealed statistically significant differences in drinking patterns, drinks consumed on a typical drinking day during the index pregnancy, and percent bingeing (3 or more drinks) during pregnancy among the three populations. In this study we compare the impacts of these and other drinking measures within and across each of the three samples and examine the quantifiable dysmorphic features of the children (including head circumference, palpebral and philtral length, and morphology of the philtrum and